STATEMENT OF CONCERN

ABOUT LIBRARY RESOURCES

please return this completed form to the Library, and it will be reviewed and considered at the next Board Meeting.

 

 

 

Name_________________________     Date___________________________

 

Address_______________________     Phone__________________________

 

City___________________________    State______________Zip__________

 

 

Do you represent (please check one)

 

_____an organization (name)_______________________________________

 

_____yourself

 

_____other

 

_____group _____________________________________________________

 

 

1. Resource on which you are commenting

 

    __ Book                  __Audio                  __Other  

       

   __Newspaper          __Magazine   

 

     Title________________________________________________________

 

  Author/Producer________________________________________________

 

 

2. What brought this title to your attention?

 

3. Have you read, viewed, or listened to the entire work?    __yes     __no

      If not, with which parts are you familiar?

 

4. Specifically, what are your objections? (Cite pages, instances, etc.)

 

 

Signature_______________________________________________________